A comparative study of mini-mental state exam and the Saint Louis University mental status for detecting mild cognitive impairment

Abstracts: Imaging / 1 (Suppl 1) (2005) more prone to disease. These data suggest that modulating tau expression is a worthwhile approach to consider for the treatment of AD. P-086

A COMPARATIVE STUDY OF MINI-MENTAL STATE EXAM AND THE SAINT LOUIS UNIVERSITY MENTAL STATUS FOR DETECTING MILD COGNITIVE IMPAIRMENT

Patricia C. Heyn1, Rosa A. Tang2, Raji Mukaila2, Tammie Nakamura1, Yong-Fang Kuo3; 1University of Colorado Health Sciences Center, Denver, CO, USA; 2University of Texas Medical Branch, Galveston, TX, USA; 3University of texas Medical Branch, Galveston, TX, USA Background: Screening instruments for cognitive impairment are frequently used in the elderly. The concept of mild cognitive impairment (MCI) is aimed to capture patients in the transition from normality to dementia. If MCI is identified patients could be informed about options for intervention and treatment that could delay the progression of this syndrome. Objective(s): To examine the Saint Louis University Mental Status (SLUMS) as a screen for mild cognitive impairment; and to test if the SLUMS is more sensitive than the Mini-Mental State Exam (MMSE) in mild cognitive screening. Methods: 100 patients age 55 and older attending the University of Texas Medical Branch Eye Clinic were consented to administer SLUMS and MMSE. After educational adjustments, 60% of the sample scored in the cognitive impairment range of the SLUMS but not on the MMSE. African American and Hispanic adults presented more cognitive impairment compared to white patients as defined by the SLUMS examination (OR, 2.80; 95% CI,1.05-7.44), independent of age, years of education and chronic diseases. Conclusion: These results suggest that the SLUMS examination is more sensitive to detect MCI than the MMSE. P-087

ATHEROSCLEROSIS AND COGNITIVE FUNCTION IN MEN WITHOUT CLINICAL SYMPTOMS OF CARDIOVASCULAR RISK

Majon Muller1,2, Andre´ Aleman3, Diederick E. Grobbee4, Edward HF de Haan3, Yvonne T. van der Schouw4; 1Slotervaart Hospital, Amsterdam, The Netherlands; 2Julius Center for Health Sciences and Pimary Care, Utrecht, The Netherlands; 3Division of Psychonomics, University, Utrecht, The Netherlands; 4Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands Background: Cardiovascular disease and cardiovascular risk factors increase the risk for cognitive decline and dementia. In order to postpone or prevent cognitive decline and eventually dementia intensive treatment of cardiovascular risk may be required already at middle age. Whether measures of subclinical disease, such as atherosclerosis, are associated with risk of cognitive decline in middle-aged and older men without clinical symptoms of cardiovascular risk is not known. Objective(s): To examine whether atherosclerosis is associated with cognitive functioning in men with no apparent cardiovascular risk. Methods: Population-based crosssectional study of 166 independently living nondemented men, aged 40 80 years, without history of cardiovascular disease or high cardiovascular risk (diabetes, hypertension, hyperlipidemia, or treatment for these risk factors). Memory function, processing speed, and executive function were assessed as measures of cognitive performance, and standardized compound scores for these domains were calculated. Carotid intima-media thickness (IMT), arterial stiffness (pulse wave velocity) and ankle brachial blood pressure index (ABI) were assessed as indicators of atherosclerosis. Atherosclerosis was defined present in men in the highest quartile of the distributions of IMT or pulse wave velocity, or an ABI ⬍0.90. Results: Of the 166 men, 24% had subclinical atherosclerosis. Linear regression analysis adjusted for potential confounders showed that men with atherosclerosis had poorer memory performance (␤ -0.57; 95% CI -1.10 ; -0.05) and slower processing capacity (␤ -0.81; 95% CI -1.69 ; 0.07). Executive function was not associated with atherosclerosis. Conclusions: This study shows that in men with no clinically manifest cardiovascular risk or disease, atherosclerosis is associated with poorer cognitive function. The

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results of this study suggest that more aggressive treatment of cardiovascular risk may be needed to prevent atherosclerosis and therefore cognitive decline and dementia. P-088

ALCOHOL CONSUMPTION AND COGNITIVE DECLINE IN A BIRACIAL POPULATION OF OLDER PERSONS

Neelum T. Aggarwal, Robert S. Wilson, Julia L. Bienias, David A. Bennett, Susan A. Everson-Rose, Denis A. Evans; Rush University Medical Center, Chicago, IL, USA Background: The relation of alcohol consumption to late life change in cognitive function has been difficult to establish. Objective: To test the association of alcohol use with rate of cognitive decline in old age. Methods: A geographically defined community in Chicago was censused, persons aged 65 years or older were invited to participate in an in-home interview, and 6,158 (79% of those eligible) did so. The interview included assessment of current and past use of alcohol and tobacco and administration of four cognitive performance tests from which a previously established global measure was derived. Cognitive testing was repeated twice at three-year intervals. A total of 4,392 (88% of those eligible) completed at least one follow-up, with a mean of 2.6 evaluations per person for a mean of 5.3 years (mean age⫽73.9, SD⫽6.5; mean education⫽12.0, SD⫽3.7; 62% women; 62% African American). Results: In mixed-effects models adjusted for age, sex, race, and lifetime socioeconomic status, current alcohol use was not associated with cognitive decline, but past alcohol use was. Rate of global cognitive decline decreased with light or moderate past use of alcohol. Report of heavy past use, however, was associated with increased cognitive decline. This curvilinear association of alcohol use with cognitive decline persisted after controlling for diverse indicators of health, measures of affect and personality, and patterns of social, cognitive, and physical activity. The association was substantially stronger in whites compared to African Americans. In addition, neither current nor past smoking was related to cognitive decline, but the association of alcohol use with cognitive decline was greatly reduced in current smokers compared to those who never smoked. Conclusion: A history of light to moderate alcohol use, but not current use, is associated with reduced cognitive decline in old age.

SUNDAY, JUNE 19, 2005 IMAGING P-089 —P-137 P-089

HIPPOCAMPAL SUBSEGMENTATION VERSUS TRADITIONAL TOTAL VOLUMETRIC MEASUREMENTS IN DETECTING EARLY CHANGES IN ALZHEIMER’S DISEASE

Udo Oyoyo, Alex Yi, Robert J. Cruise, James Larsen, Daniel K. Kido, Wolff Kirsch; Loma Linda University, Loma Linda, CA, USA Background: MRI scans of the head have shown hippocampal atrophy to significantly correlate with AD. However, gross total volumetric measurements frequently underestimate the incidence of pathologic changes in this disease. During our current Alzheimer’s study, we have noted a subset of patients that demonstrate hippocampal atrophy segmentally in either the head or body. Objective: The purpose of this study was to compare hippocampal subsegmentation volume changes with total volumetric changes in normal controls and cognitively impaired (CI) subjects to determine which technique more accurately detects patients with early AD. Of particular interest were those controls that converted to cognitively impaired (CI) status and CI subjects who converted to early AD. Methods: Repeated T1-weighted MR coronal images were collected with a threedimensional MP-RAGE sequence from 20 healthy controls and 22 CI subjects utilizing a 1.5 T Siemens (Vision) MRI scanner. The region of interest (border of the hippocampus) was traced slice-by-slice and the corresponding volumes were determined. Images were also assessed to visualize the anatomic landmarks in order to subsegment the hippocampus